Polycystic Ovarian Syndrome in Adolescents: Metabolic Profile at Diagnosis, During and After Treatment with Oral Contraceptive

ARCARI, ANDREA; GRYNGARTEN M; BALLERINI MG; FREIRE, ANALÍA; RODRIGUEZ ME; ROPELATO, M.G.; BERGADÁ I; ESCOBAR, MARÍA EUGENIA

Dublin

Congreso; 53rd Annual European Society For Paediatric Endocrinology; 2014

Background: Obesity and unfavorable metabolic profile (insulin resistance and/or dyslipidemia) are frequently observed in Polycystic Ovarian Syndrome in Adolescents (PCOS) girls regardless of weight. Objective and hypotheses: To evaluate clinical features and metabolic profile in PCOS adolescents, before, during and after Oral Contraceptive (OC) treatment. Method: We performed a retrospective study on 51 girls with PCOS diagnosed according to the Androgen Excess Society criteria. Menstrual history, BMI (BMI?SDS), clinical and biochemical hyperandrogenism and metabolic profile were analyzed at diagnosis (age 16G1.8 years). A group of 26 patients was assessed during OC treatment (etinilestradiol?drospirenone) for at least 2 years and after treatment withdrawal. Results: At diagnosis, all patients had menstrual disturbances (gynecological age: 4.0G2.0 years; 30 oligo-amenorrhea, 11 poly-oligomenorrhea, five primary amenorrhea, and five secondary amenorrhea). BMI?SDS 0.67G1.10 (40% overweight or obese). Hirsutism was present in 98% (Ferriman? Gallwey score 13G4), 67% had acne and 21% acanthosis nigricans. Forty-nine percent of patients had elevated serum testosterone and androstenedione (0.76G0.33 and 3.73G 1.42 ng/ml respectively). BMI?SDS and HOMA-IR were positively associated to free androgen index (rZ0.48 and rZ0.53, P!0.001 respectively). Elevated HOMA-IR and dyslipidemia (low HDL and high triglyceride levels) were present in 31 and 12% respectively. BMI and HOMA-IR remained unchanged throughout and after treatment, whereas total cholesterol, LDL cholesterol and triglyceride levels increased during OC treatment (P!0.0001) and decreased (P!0.0001) upon OC withdrawal. HDL cholesterol increased during treatment (P!0.0001) and remained elevated after treatment. Conclusion: Adolescent girls with PCOS may have overweight, insulin resistance and/or dyslipidemia at diagnosis. We strongly recommend the evaluation of metabolic profile in PCOS adolescents at diagnosis to further prevent future consequences. OC treatment in our cohort did not show a long term impact on BMI, insulin resistance or dyslipidemia.